With the expensive costs of incontinence pads, adult diapers, soiled clothing, and social stigma, a better question would be, Are you OK with leaking urine? If you suffer from urinary incontinence you are not alone. An estimated 25-51% of all women have leaked once in the last year, and 17-32% of women are leaking regularly with percentages increasing with age. Even though many women suffer from a weak bladder, you don’t need to live with it!
Recently extreme intensity workouts like Cross-Fit are glorifying leaking. While leaking is common in some circles, it is NEVER normal. For a doctor to accept leaking or merely suggest pads does their patient a disservice. Leaking urine is treatable with conservative measures. The sooner you accept that leaking is a problem, and act to heal your pelvis, the more effective the treatments can be. The longer you wait, the worse the problem will get, and incontinence increases with age.
The truth is urinary incontinence is just a symptom of a system out of balance. The pelvic floor works with the muscles of the abdomen, back, diaphragm and hips to give stability to your “core.” Ideally these muscles are all strong and automatically work together to help us, run, jump, push, throw, stand, and not leak. If any of these muscles work without their pelvic floor partner you will leak. For instance, some women in Cross-Fit override their normal core balance by bearing down on their abdominal muscles which makes them leak with jumping rope, and heavy lifting. People with breathing disorders like asthma, or chronic coughing have a higher incidence of pelvic floor problems as well. When muscles or the deep core are out of balance we end up with increased chances of injury to our entire body, pain or decreased sensation with sex, pain or weakness with movement, constipation, all sorts of pain, and yes, incontinence too.
Leaking can occur with increased abdominal pressure. Stress incontinence describes leaking urine when you cough, sneeze, or jump. If you leak with a sudden urge to go to the restroom that is called urge incontinence. Sometimes people may have both stress and urge incontinence known as mixed incontinence. Other urinary symptoms may include feeling urgency without leaking, or feeling the need to urinate frequently (6-7x daily is normal for most people.) Urinary urgency and frequency are often dysfunctions of the pelvic floor that can be trained out.
Urinary incontinence may result from bladder dysfunction, sphincter dysfunction, both, or nervous system dysfunction. The pelvic floor muscles may be either too weak or too tight to effectively close the urethral sphincter. For women the weight of pregnancy is the major cause incontinence. All that baby weight pushing on the pelvic organs can weaken ligaments and muscles that normally keep you continent and your organs in place. For men and those that have never been pregnant being overweight, chronic cough and constipation put extra pressure on the pelvic organs and pelvic floor. Pelvic surgery, especially prostatectomy can have damaging effects. Take a look at the image above, all the pelvic organs are very close together, it’s easy to understand that pressure from any one place can affect leaking.
In Pelvic Physical Therapy, we look at the whole system of your body. We first mobilize restricted areas, and support the body parts that need a break. Then we retrain the pelvic floor muscles with specific biofeedback guided exercise. We progress exercise to activities that you are doing on a regular basis to improve carryover. We also educate patients about postures and behaviors that might be making things worse. Up to 40% of women are unable to correctly engage their pelvic floor when doing kegels. You need some more direction and help, and as pelvic PTs we can provide it. Need to find a pelvic physical therapist in your area? Try the American Physical Therapy Association. Search the APTA.org website “Find a PT” and the specialty of “Women’s Health” for all pelvic therapy treatments.
To get back the the first question: Yes! It is ok to leak, and no one should fee shame or hide that they are suffering. No, you don’t have to live with it. Medical help is available. Physical therapy is a great conservative first step, then if you need extra help your doctor can discuss options such as medications, surgery, or supportive devices to find a solution.
Have more questions? Email us info@AlivePT.com, or call to set up your free consultation.